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2018 | 72 | 33-44
Article title

Glucose abnormalities detected by oral glucose tolerance test in patients with acute myocardial infarction: clinical significance, epidemiology, natural course and therapeutic concerns

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PL
Zaburzenia metabolizmu glukozy wykryte w doustnym teście obciążenia glukozą u chorych z zawałem serca: znaczenie kliniczne, epidemiologia, przebieg naturalny i problemy terapeutyczne
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Abstracts
EN
Two-hour post load glycemia (2h-PG) obtained during the oral glucose tolerance test (OGTT) is related to adverse cardiovascular outcomes more significantly than fasting glycemia, and the association of 2h-PG with cardiovascular morbidity is graded and independent. An abnormal value of 2h-PG is defined as glycemia ≥ 7.8 mmol/l (140 mg/dl) in most studies. Patients with acute myocardial infarction with abnormal 2h-PG compared to patients with normal 2h-PG have a significantly higher long-term mortality and more concomitant diseases, however, it has not been shown that those subjects have a higher risk of myocardial infarction, coronary revascularization or stroke. Studies have shown that in some patients the glucometabolic status changes after the acute phase of the disease, and that those changes have a prognostic importance. In this review article the authors presented the significance, epidemiology, natural course of glucometabolic disturbances and the therapeutic concerns of hypoglycemic treatment.
PL
W porównaniu z glikemią na czczo, wartość glikemii po dwóch godzinach (2h-PG) uzyskana w doustnym teście obciążenia glukozą (OGTT) jest parametrem lepiej korelującym z przyszłymi niekorzystnymi zdarzeniami sercowo-naczyniowymi, a jej związek z zapadalnością na chorobę wieńcową oraz ze śmiertelnością jest stopniowy i niezależny. Nieprawidłowy wynik 2h-PG w większości publikowanych prac definiuje się jako ≥ 7,8 mmol/l (140 mg/dl). U chorych z zawałem serca, u których stwierdza się nieprawidłowy wynik 2h-PG, w porównaniu z chorymi z pra-widłowym 2h-PG, rokowanie jest gorsze. Charakteryzują się również częstszym występowaniem chorób towarzyszących. Są to pacjenci, których śmiertelność odległa jest znamiennie wyższa, jednak dotychczas nie wykazano jednoznacznie, aby byli to chorzy, u których częściej występuje ponowny zawał serca, rewaskularyzacja wieńcowa czy udar mózgu. Wskazuje się również na fakt, iż u części chorych stan glukometaboliczny zmienia się po ostrej fazie choroby, co ma wpływ na śmiertelność. W prezentowanej pracy przedstawiono znaczenie zaburzeń metabolizmu glukozy, ich epidemiologię, przebieg naturalny oraz poruszono problem leczenia hipoglikemizującego.
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72
Pages
33-44
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Contributors
  • Katedra Kardiologii, Wrodzonych Wad Serca i Elektroterapii, Oddział Kliniczny Kardiologii, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu, pawel.francuz@wp.pl
  • Katedra Kardiologii, Wrodzonych Wad Serca i Elektroterapii, Oddział Kliniczny Kardiologii, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu
  • Katedra Kardiologii, Wrodzonych Wad Serca i Elektroterapii, Oddział Kliniczny Kardiologii, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu
  • Katedra Kardiologii, Wrodzonych Wad Serca i Elektroterapii, Oddział Kliniczny Kardiologii, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu
  • Katedra Kardiologii, Wrodzonych Wad Serca i Elektroterapii, Oddział Kliniczny Kardiologii, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu
  • Katedra Kardiologii, Wrodzonych Wad Serca i Elektroterapii, Oddział Kliniczny Kardiologii, Śląski Uniwersytet Medyczny w Katowicach, Śląskie Centrum Chorób Serca w Zabrzu
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bwmeta1.element.psjd-9680cc8d-a499-4882-b99d-3e87774e6618
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